How do you guys pay for it all

kgasmart

16 months post BOT SCC surgery and then 30 rads last February-March; I hit my out-of-pocket max ($5,900) each of the past two years and now it looks like I'm heading that way for the third year in a row. Just had a CT scan that's likely to set me back $1k, ordered by my radonc, whose appointment/endoscopy cost me nearly $400... a recent visit to the ENT whose bill I haven't gotten yet... and an upcoming visit with my surgeon which is likely to be another $400 at least, all this before the deductible even kicks in at $5,200.

 

Cancer is extraordinarily expensive. How do you guys pay for it all? If this is the way it's going to be in terms of medical bills going forward - and all this without (so far) a recurrence! - it's just going to be a tough to pay for it all.

ERomanO

HSA

I started a Health Savings Account while I was still working and contributed as much as possible during that time.  When I retired I still tried to contribute the max each year and wound up with a very healthy balance.  This turned out to be critical because my third year of retirement was when I was diagnosed with cancer and had all the bills come poouring in.  Even though it's a large chunk of change to be just sitting idle in an account, I still have enough to cover about 2 1/2 years of out-of-pocket costs.  The big "C" isn't the only major medical expense that can come our way so it's nice to have a balance waiting just in case.

johnsonbl

If you have the option...

To get your imaging done at a free standing or office based practice (vs. a hospital based facility) you can save quite a bit of money.  Hospital based services can cost 40-50% more than things done in an office based setting.  If you are already having these done at the lower priced settings then there isn't too much you can do.

With time, your utilization will decrease.  I'm almost 2 years post treatment and my next visit will include a CT.  If that's all clear then my team has said that I go to annual office visits...and that's it.

kgasmart

ERomanO said:

HSA

I started a Health Savings Account while I was still working and contributed as much as possible during that time.  When I retired I still tried to contribute the max each year and wound up with a very healthy balance.  This turned out to be critical because my third year of retirement was when I was diagnosed with cancer and had all the bills come poouring in.  Even though it's a large chunk of change to be just sitting idle in an account, I still have enough to cover about 2 1/2 years of out-of-pocket costs.  The big "C" isn't the only major medical expense that can come our way so it's nice to have a balance waiting just in case.

I do have an HSA through work

...and I upped my contributon significantly this year to try and put aside the money that would be needed. But now my wife has some medical issues she has to have addressed, and with my issues it's turning out to not be enough. Argh.

caregiver wife

Out of pocket cost assistance

Our oncologist's office had a lady in the billing office that helped find assistance.  The year husband's billings exceeded 1 Million, she found a $50,000 grant to help offset our out of pocket.  Our local United Way also helped me find possible assitance sources.  Availabe money is always changing, so you must keep searching.

Crystal

 

ERomanO

Logan51 said:

$180,000

That's approximately what my "charged billings" were from the Chemo, Rads, ENT, Imaging and 4 nights in a Hospital- 10 years ago. I had the best of two United Healthcare plans at work: $1-K Max/year out of pocket.

Diagnosed in November of 2008 w/PS/CT and biopsy Op., I hit the $1-K. Had been on an expensive medicine all year for a work-related injury.

With an 11th-hour biopsy Op. and Ops. for Power Port and G-tube in January of 2009, then tx starting Feb. 9th- reached the $1-K right away.

Between the PS/CT and Periodontist, along w/Chemo & Rad Dr. visits, got to $1-K in 2010, also. So, C cost me a little over $3-K, basically. However, I've spent almost $14-K out of pocket on Dental bills since tx over the 10 years, so that has been a major hit to my wallet.

I kept all my billings, though, AND WAS SHOCKED BY WHAT I SAW: the 34 Radiation sessions accepted only 33% of their billed charges from United!!! Know the Hospital and Chemo, itself, also accepted less than billed charges, but neither was near the % less. Only the Chemo, Rad and ENT Dr.s refused to accept less than billed charges. With the many Rad sessions, and my getting zapped in 20 places/session for a total of 6,800 cGys, being the most expensive by far= the United Healthcare actually only payed around $80,000 of the $180,00 billed charges! SO, for everyone- try to negotiate the Radiation expenses.

I have read that for people on Medicaid, for instance, the C costs are reduced to a percentage of one's income, but the payments/year continue long after tx is done.

Sorry to hear about how much C is costing you. Our other UHC plan payed around 80%, and remember a coworker got $ clobbered after open heart Surgery and rehab.

 

Very good point about the

Very good point about the possibility of a lot of dental work that isn't covered by a medical plan.

johnsonbl

ERomanO said:

Very good point about the

Very good point about the possibility of a lot of dental work that isn't covered by a medical plan.

The dental work...

I had to have my wisdom teeth pulled before radiation as a preventative measure (because of your higher risk of necrosis after radiation and the fact that your wisdom teeth are set up against the jaw bone) but my insurance company wouldn't pay for it because it wasn't medically necessary.  Which makes no sense, since it's a hell of a lot cheaper to pay for getting wisdom teeth out than to pay to have my jaw put back together if something were to happen 5 years down the line.  Idiots.

Fortunately, I work at the AMC where I was treated and I just had the hospital dentists come in during my TORS surgery and pull my wisdom teeth while I was unconsious...killed 2 birds with one stone.  Didn't cost me anything since it was during the inpatient admission.  LOL.  Suckers.

ricksmithgolfer

Total of $400.00 out of pocket

I finished HPV 16 positive tonsil / lymph node cancer treatment last September. Stage 1 in the new staging system. (4a in old system) I am retired and have both Medicare parts A & B and a United Healthcare HMO plan thru my wifes work. Because my wifes company is under 20 employees, Medicare is your primary insurance. If 20 or more employess Medicare would be your secondary insurance. This rule is followed by all insurance companies. When choosing my care for my treatment one of the main things I had to consider was whether my doctors accepted Medicare Assignment. This means they accept whatever payment Medicare authorizes. I was very fortunate to find that Scripps Clinic in my area accepted this payment plan. Scripps is also tied in with MD Anderson so my treatments were top notch. I am currently NED. Most of my copays were covered by my secondary insurance. The only thing I paid for was the copay on both my PET Scans, I was really fortunate.

I have been procrastinating on writing my full story about my treatment and now am in the mode of starting that. I will be posting my story in the coming weeks. Thanks to all who have been there to help get me thru this journey. My story is about the same as ERomanO's. I visit the site just about everyday and it really helps to hear how you all are doing. Thanks again to all my fellow cancer warriors. I was lucky to find this site a month before I started my treatment.

Rick

accordiongirl

Check with your cancer center

Some places have funds set aside to help patients cover costs - either with meds or basic living expenses, etc.  Here i will brag just a bit.......after my dad passed from cancer, my teen daughter, who was very close to gpa, donated all of her "charity" money as well as her spending money to the cancer center where dad got his treatment with the condition that it be used to help folks who couldn't afford their meds.  Now, to be sure, her $200 wasn't going to help much, but it was going to help someone.  Four years later, the foundation at that cancer center used my daughter's story as part of their fundraising gala - and raised over $500,000.00 to help folks with costs they couldn't cover.  They've since started an endowment, so there will always be funds there for people who need it. 

i mention this not to toot my daughter's horn, but to let folks know to ask the financial person at their clinic if there is such a fund available - it could be that there are resources for you that are not publicized.   Don't be afraid to ask.  Cancer is stupidly expensive. 

~ accordiongirl

ERomanO

johnsonbl said:

The dental work...

I had to have my wisdom teeth pulled before radiation as a preventative measure (because of your higher risk of necrosis after radiation and the fact that your wisdom teeth are set up against the jaw bone) but my insurance company wouldn't pay for it because it wasn't medically necessary.  Which makes no sense, since it's a hell of a lot cheaper to pay for getting wisdom teeth out than to pay to have my jaw put back together if something were to happen 5 years down the line.  Idiots.

Fortunately, I work at the AMC where I was treated and I just had the hospital dentists come in during my TORS surgery and pull my wisdom teeth while I was unconsious...killed 2 birds with one stone.  Didn't cost me anything since it was during the inpatient admission.  LOL.  Suckers.

Interesting

I still have two impacted lower wisdom teeth, but there was no mention of them needing to be removed... and the right jaw had radiation very close to it.

Logan51

$180,000

That's approximately what my "charged billings" were from the Chemo, Rads, ENT, Imaging and 4 nights in a Hospital- 10 years ago. I had the best of two United Healthcare plans at work: $1-K Max/year out of pocket.

Diagnosed in November of 2008 w/PS/CT and biopsy Op., I hit the $1-K. Had been on an expensive medicine all year for a work-related injury.

With an 11th-hour biopsy Op. and Ops. for Power Port and G-tube in January of 2009, then tx starting Feb. 9th- reached the $1-K right away.

Between the PS/CT and Periodontist, along w/Chemo & Rad Dr. visits, got to $1-K in 2010, also. So, C cost me a little over $3-K, basically. However, I've spent almost $14-K out of pocket on Dental bills since tx over the 10 years, so that has been a major hit to my wallet.

I kept all my billings, though, AND WAS SHOCKED BY WHAT I SAW: the 34 Radiation sessions accepted only 33% of their billed charges from United!!! Know the Hospital and Chemo, itself, also accepted less than billed charges, but neither was near the % less. Only the Chemo, Rad and ENT Dr.s refused to accept less than billed charges. With the many Rad sessions, and my getting zapped in 20 places/session for a total of 6,800 cGys, being the most expensive by far= the United Healthcare actually only payed around $80,000 of the $180,00 billed charges! SO, for everyone- try to negotiate the Radiation expenses.

I have read that for people on Medicaid, for instance, the C costs are reduced to a percentage of one's income, but the payments/year continue long after tx is done.

Sorry to hear about how much C is costing you. Our other UHC plan payed around 80%, and remember a coworker got $ clobbered after open heart Surgery and rehab.

 

ProustLover

AFLAC helped

My husband had good insurance through my employer, which covered most costs from the initial tongue surgery, then neck dissection, chemo and radiation.  The radiation did have a co-pay of $40 per treatment (around 33 treatments).  A few years prior, I'd purchased AFLAC insurance, which was optional through my employer.  (My own mother had breast cancer, so I figured the coverage might come in handy for me.)  We submitted paperwork to AFLAC throughout treatment, and process was very user friendly and swift.  I think we got around $17,000, based on his type of cancer and treatment involved.  It's intended to help with cancer-related expenses, and it did.  

kgasmart

ProustLover said:

AFLAC helped

My husband had good insurance through my employer, which covered most costs from the initial tongue surgery, then neck dissection, chemo and radiation.  The radiation did have a co-pay of $40 per treatment (around 33 treatments).  A few years prior, I'd purchased AFLAC insurance, which was optional through my employer.  (My own mother had breast cancer, so I figured the coverage might come in handy for me.)  We submitted paperwork to AFLAC throughout treatment, and process was very user friendly and swift.  I think we got around $17,000, based on his type of cancer and treatment involved.  It's intended to help with cancer-related expenses, and it did.  

Hm

Never thought of AFLAC, just went on their web site to see what they say about preexisting conditions - if they were to sell me a policy there'd be no benefits paid if I need cancer care/have a recurrence within the first 12 months, but after that looks like it would. Definitely might be worthwhile

hlrowe

I think my total 2012

I think my total 2012 billings were $350,000. I had an out of pocket of $5,500.00 through my employer's Anthem.

But, I spent around $18K OOP on subsequent dental treatments. A LOT of new crowns.